Skip to main content
Erschienen in: Der Gastroenterologe 4/2019

24.06.2019 | Endoskopische retrograde Cholangiopankreatikographie | CME

Anomalien im pankreatikobiliären System

verfasst von: Dirk Walter, Prof. Dr. Michael Jung

Erschienen in: Die Gastroenterologie | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Anatomische Varianten des pankreatikobiliären Systems sind häufig und vielfältig. Eine genaue Kenntnis der verschiedenen Varianten stellt die Grundlage für die Erkennung und Einordnung von pathologischen oder kontrollbedürftigen Befunden dar, wie es beispielsweise im Rahmen der endoskopischen retrograden Cholangiopankreatikographie (ERCP) gefordert ist. In dieser Übersichtsarbeit wird auf die Embryologie von Gallen- und Pankreasgängen eingegangen und mögliche Varianten der regulären Anatomie beim Erwachsenen beschrieben. Zudem wird bei klinischer Relevanz die diagnostische und teilweise auch therapeutische Herangehensweise dargestellt.
Literatur
1.
Zurück zum Zitat Roskams T, Desmet V (2008) Embryology of extra- and Intrahepatic bile ducts, the ductal plate. Anat Rec 291(6):628–635CrossRef Roskams T, Desmet V (2008) Embryology of extra- and Intrahepatic bile ducts, the ductal plate. Anat Rec 291(6):628–635CrossRef
2.
Zurück zum Zitat Türkvatan A, Erden A, Türkoğlu MA, Yener Ö (2013) Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol 14(6):905–913CrossRef Türkvatan A, Erden A, Türkoğlu MA, Yener Ö (2013) Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol 14(6):905–913CrossRef
4.
Zurück zum Zitat Huang TL, Cheng YF, Chen CL, Chen TY, Lee TY (1996) Variants of the bile ducts: clinical application in the potential donor of living-related hepatic transplantation. Transplant Proc 28(3):1669–1670PubMed Huang TL, Cheng YF, Chen CL, Chen TY, Lee TY (1996) Variants of the bile ducts: clinical application in the potential donor of living-related hepatic transplantation. Transplant Proc 28(3):1669–1670PubMed
5.
Zurück zum Zitat Ragab A, Lopez-Soler RI, Oto A, Testa G (2013) Correlation between 3D-MRCP and intra-operative findings in right liver donors. Hepatobiliary Surg Nutr 2(1):7–13PubMedPubMedCentral Ragab A, Lopez-Soler RI, Oto A, Testa G (2013) Correlation between 3D-MRCP and intra-operative findings in right liver donors. Hepatobiliary Surg Nutr 2(1):7–13PubMedPubMedCentral
6.
Zurück zum Zitat Nakamura T, Tanaka K, Kiuchi T, Kasahara M, Oike F, Ueda M, Kaihara S, Egawa H, Ozden I, Kobayashi N, Uemoto S (2002) Anatomical variations and surgical strategies in right lobe living donor liver transplantation: lessons from 120 cases. Transplantation 73(12):1896–1903CrossRef Nakamura T, Tanaka K, Kiuchi T, Kasahara M, Oike F, Ueda M, Kaihara S, Egawa H, Ozden I, Kobayashi N, Uemoto S (2002) Anatomical variations and surgical strategies in right lobe living donor liver transplantation: lessons from 120 cases. Transplantation 73(12):1896–1903CrossRef
7.
Zurück zum Zitat Varotti G, Gondolesi GE, Goldman J, Wayne M, Florman SS, Schwartz ME, Miller CM, Sukru E (2004) Anatomic variations in right liver living donors1 1No competing interests declared. J Am Coll Surg 198(4):577–582CrossRef Varotti G, Gondolesi GE, Goldman J, Wayne M, Florman SS, Schwartz ME, Miller CM, Sukru E (2004) Anatomic variations in right liver living donors1 1No competing interests declared. J Am Coll Surg 198(4):577–582CrossRef
10.
Zurück zum Zitat Choi E, Byun JH, Park BJ, Lee M‑G (2007) Duplication of the extrahepatic bile duct with anomalous union of the pancreaticobiliary ductal system revealed by MR cholangiopancreatography. Br J Radiol 80(955):e150–e154CrossRef Choi E, Byun JH, Park BJ, Lee M‑G (2007) Duplication of the extrahepatic bile duct with anomalous union of the pancreaticobiliary ductal system revealed by MR cholangiopancreatography. Br J Radiol 80(955):e150–e154CrossRef
11.
Zurück zum Zitat Kolli S, Etienne D, Reddy M, Shahzad G (2018) A review of double common bile duct and its sequelae. Gastroenterol Res 11(1):1–4CrossRef Kolli S, Etienne D, Reddy M, Shahzad G (2018) A review of double common bile duct and its sequelae. Gastroenterol Res 11(1):1–4CrossRef
12.
Zurück zum Zitat Yamashita K, Oka Y, Urakami A, Iwamoto S, Tsunoda T, Eto T (2002) Double common bile duct: a case report and a review of the Japanese literature. Surgery 131(6):676–681CrossRef Yamashita K, Oka Y, Urakami A, Iwamoto S, Tsunoda T, Eto T (2002) Double common bile duct: a case report and a review of the Japanese literature. Surgery 131(6):676–681CrossRef
14.
Zurück zum Zitat Shiba H, Misawa T, Ito R, Ohki K, Igarashi T, Yanaga K (2014) Duplicated gallbladder. Int Surg 99(1):77–78CrossRef Shiba H, Misawa T, Ito R, Ohki K, Igarashi T, Yanaga K (2014) Duplicated gallbladder. Int Surg 99(1):77–78CrossRef
15.
Zurück zum Zitat Soares KC, Goldstein SD, Ghaseb MA, Kamel I, Hackam DJ, Pawlik TM (2017) Pediatric choledochal cysts: diagnosis and current management. Pediatr Surg Int 33(6):637–650CrossRef Soares KC, Goldstein SD, Ghaseb MA, Kamel I, Hackam DJ, Pawlik TM (2017) Pediatric choledochal cysts: diagnosis and current management. Pediatr Surg Int 33(6):637–650CrossRef
16.
Zurück zum Zitat Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977) Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 134(2):263–269CrossRef Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977) Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 134(2):263–269CrossRef
17.
Zurück zum Zitat Moslim MA, Gunasekaran G, Vogt D, Cruise M, Morris-Stiff G (2015) Surgical management of Caroli’s disease: single center experience and review of the literature. J Gastrointest Surg 19(11):2019–2027CrossRef Moslim MA, Gunasekaran G, Vogt D, Cruise M, Morris-Stiff G (2015) Surgical management of Caroli’s disease: single center experience and review of the literature. J Gastrointest Surg 19(11):2019–2027CrossRef
19.
Zurück zum Zitat Mortelé KJ, Rocha TC, Streeter JL, Taylor AJ (2006) Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics 26(3):715–731CrossRef Mortelé KJ, Rocha TC, Streeter JL, Taylor AJ (2006) Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics 26(3):715–731CrossRef
20.
Zurück zum Zitat Kanth R, Samji NS, Inaganti A, Komanapalli SD, Rivera R, Antillon MR, Roy PK (2014) Endotherapy in symptomatic pancreas divisum: a systematic review. Pancreatology 14(4):244–250CrossRef Kanth R, Samji NS, Inaganti A, Komanapalli SD, Rivera R, Antillon MR, Roy PK (2014) Endotherapy in symptomatic pancreas divisum: a systematic review. Pancreatology 14(4):244–250CrossRef
21.
Zurück zum Zitat Kozu T, Suda K, Toki F (1995) Pancreatic development and anatomical variation. Gastrointest Endosc Clin N Am 5(1):1–30CrossRef Kozu T, Suda K, Toki F (1995) Pancreatic development and anatomical variation. Gastrointest Endosc Clin N Am 5(1):1–30CrossRef
22.
Zurück zum Zitat Schulte SJ (1994) Embryology, normal variation, and congenital anomalies of the pancreas. In: Stevenson GW, Freeny PC, Margulis ARBH (Hrsg) Margulis’ and Burhenne’s alimentary tract radiology 5. Aufl. Mosby, St. Louis, S 1039–1051 Schulte SJ (1994) Embryology, normal variation, and congenital anomalies of the pancreas. In: Stevenson GW, Freeny PC, Margulis ARBH (Hrsg) Margulis’ and Burhenne’s alimentary tract radiology 5. Aufl. Mosby, St. Louis, S 1039–1051
23.
Zurück zum Zitat Chronic Pancreatitis German Society of Digestive and Metabolic Diseases (DGVS) A, Hoffmeister A, Mayerle J, Beglinger C, Büchler MW, Bufler P, Dathe K, Fölsch UR, Friess H, Izbicki J, Kahl S, Klar E, Keller J, Knoefel WT, Layer P, Loehr M, Meier R, Riemann JF, Rünzi M et al (2012) S3-Consensus guidelines on definition, etiology, diagnosis and medical, endoscopic and surgical management of chronic pancreatitis German Society of Digestive and Metabolic Diseases (DGVS). Z Gastroenterol 50(11):1176–224. http://www.thieme-connect.de/DOI/DOI?10.1055/s-0032-1325479. Zugegriffen: 5. Apr. 2019 Chronic Pancreatitis German Society of Digestive and Metabolic Diseases (DGVS) A, Hoffmeister A, Mayerle J, Beglinger C, Büchler MW, Bufler P, Dathe K, Fölsch UR, Friess H, Izbicki J, Kahl S, Klar E, Keller J, Knoefel WT, Layer P, Loehr M, Meier R, Riemann JF, Rünzi M et al (2012) S3-Consensus guidelines on definition, etiology, diagnosis and medical, endoscopic and surgical management of chronic pancreatitis German Society of Digestive and Metabolic Diseases (DGVS). Z Gastroenterol 50(11):1176–224. http://​www.​thieme-connect.​de/​DOI/​DOI?​10.​1055/​s-0032-1325479. Zugegriffen: 5. Apr. 2019
24.
Zurück zum Zitat Bertin C, Pelletier A‑L, Vullierme MP, Bienvenu T, Rebours V, Hentic O, Maire F, Hammel P, Vilgrain V, Ruszniewski P, Lévy P (2012) Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol 107(2):311–317CrossRef Bertin C, Pelletier A‑L, Vullierme MP, Bienvenu T, Rebours V, Hentic O, Maire F, Hammel P, Vilgrain V, Ruszniewski P, Lévy P (2012) Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol 107(2):311–317CrossRef
26.
Zurück zum Zitat Woods AC et al (1950) Annular pancreas. Ann Surg 132(6):1116–1127CrossRef Woods AC et al (1950) Annular pancreas. Ann Surg 132(6):1116–1127CrossRef
27.
Zurück zum Zitat Baggott BB, Long WB (1991) Annular pancreas as a cause of extrahepatic biliary obstruction. Am J Gastroenterol 86(2):224–226PubMed Baggott BB, Long WB (1991) Annular pancreas as a cause of extrahepatic biliary obstruction. Am J Gastroenterol 86(2):224–226PubMed
29.
Zurück zum Zitat Anderson MA, Fisher L, Jain R, Evans JA, Appalaneni V, Ben-Menachem T, Cash BD, Decker GA, Early DS, Fanelli RD, Fisher DA, Fukami N, Hwang JH, Ikenberry SO, Jue TL, Khan KM, Krinsky ML, Malpas PM, Maple JT et al (2012) Complications of ERCP. Gastrointest Endosc 75(3):467–473CrossRef Anderson MA, Fisher L, Jain R, Evans JA, Appalaneni V, Ben-Menachem T, Cash BD, Decker GA, Early DS, Fanelli RD, Fisher DA, Fukami N, Hwang JH, Ikenberry SO, Jue TL, Khan KM, Krinsky ML, Malpas PM, Maple JT et al (2012) Complications of ERCP. Gastrointest Endosc 75(3):467–473CrossRef
31.
Zurück zum Zitat Kamisawa T, Takuma K, Anjiki H, Egawa N, Kurata M, Honda G, Tsuruta K, Sasaki T (2009) Pancreaticobiliary maljunction. Clin Gastroenterol Hepatol 7(11):S84–S88CrossRef Kamisawa T, Takuma K, Anjiki H, Egawa N, Kurata M, Honda G, Tsuruta K, Sasaki T (2009) Pancreaticobiliary maljunction. Clin Gastroenterol Hepatol 7(11):S84–S88CrossRef
32.
Zurück zum Zitat Kimura K, Ohto M, Saisho H, Unozawa T, Tsuchiya Y, Morita M, Ebara M, Matsutani S, Okuda K (1985) Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Baillieres Clin Gastroenterol 89(6):1258–1265 Kimura K, Ohto M, Saisho H, Unozawa T, Tsuchiya Y, Morita M, Ebara M, Matsutani S, Okuda K (1985) Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Baillieres Clin Gastroenterol 89(6):1258–1265
33.
Zurück zum Zitat Jung M, Pimentel F, Winter J, Doertenbach J (1993) The common channel syndrome in adults. Z Gastroenterol 31(2):147–150PubMed Jung M, Pimentel F, Winter J, Doertenbach J (1993) The common channel syndrome in adults. Z Gastroenterol 31(2):147–150PubMed
34.
Zurück zum Zitat Hsia CY, Wu CW, Lui WY (1999) Heterotopic pancreas: a difficult diagnosis. J Clin Gastroenterol 28(2):144–147CrossRef Hsia CY, Wu CW, Lui WY (1999) Heterotopic pancreas: a difficult diagnosis. J Clin Gastroenterol 28(2):144–147CrossRef
35.
Zurück zum Zitat Lucena JF, Alvarez OA, Gross GW (1997) Endoscopic resection of heterotopic pancreas of the minor duodenal papilla: case report and review of the literature. Gastrointest Endosc 46(1):69–72CrossRef Lucena JF, Alvarez OA, Gross GW (1997) Endoscopic resection of heterotopic pancreas of the minor duodenal papilla: case report and review of the literature. Gastrointest Endosc 46(1):69–72CrossRef
38.
Zurück zum Zitat Kimura W, Nagai H, Kuroda A, Muto T, Esaki Y (1995) Analysis of small cystic lesions of the pancreas. Int J Pancreatol 18(3):197–206PubMed Kimura W, Nagai H, Kuroda A, Muto T, Esaki Y (1995) Analysis of small cystic lesions of the pancreas. Int J Pancreatol 18(3):197–206PubMed
39.
Zurück zum Zitat Tanaka M, Fernández-del Castillo C, Kamisawa T, Jang JY, Levy P, Ohtsuka T, Salvia R, Shimizu Y, Tada M, Wolfgang CL (2017) Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology 17(5):738–753CrossRef Tanaka M, Fernández-del Castillo C, Kamisawa T, Jang JY, Levy P, Ohtsuka T, Salvia R, Shimizu Y, Tada M, Wolfgang CL (2017) Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology 17(5):738–753CrossRef
41.
Zurück zum Zitat Lång K, Lasson Å, Müller MF, Thorlacius H, Toth E, Olsson R (2012) Dorsal agenesis of the pancreas—a rare cause of abdominal pain and insulin-dependent diabetes. Acta Radiol 53(1):2–4CrossRef Lång K, Lasson Å, Müller MF, Thorlacius H, Toth E, Olsson R (2012) Dorsal agenesis of the pancreas—a rare cause of abdominal pain and insulin-dependent diabetes. Acta Radiol 53(1):2–4CrossRef
42.
Zurück zum Zitat Oeda S, Otsuka T, Akiyama T, Ario K, Masuda M, Taguchi S, Shono T, Kawazoe S (2010) Recurrent acute pancreatitis caused by a gastric duplication cyst communicating with an aberrant pancreatic duct. Intern Med 49(14):1371–1375CrossRef Oeda S, Otsuka T, Akiyama T, Ario K, Masuda M, Taguchi S, Shono T, Kawazoe S (2010) Recurrent acute pancreatitis caused by a gastric duplication cyst communicating with an aberrant pancreatic duct. Intern Med 49(14):1371–1375CrossRef
Metadaten
Titel
Anomalien im pankreatikobiliären System
verfasst von
Dirk Walter
Prof. Dr. Michael Jung
Publikationsdatum
24.06.2019
Verlag
Springer Medizin
Erschienen in
Die Gastroenterologie / Ausgabe 4/2019
Print ISSN: 2731-7420
Elektronische ISSN: 2731-7439
DOI
https://doi.org/10.1007/s11377-019-0369-7

Weitere Artikel der Ausgabe 4/2019

Der Gastroenterologe 4/2019 Zur Ausgabe

Einführung zum Thema

Transplantationsmedizin

Mitteilungen Netzwerk gegen Darmkrebs

Mitteilungen Netzwerk gegen Darmkrebs

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.